Index

Index

275

postoperative

living-related, 201–207

Corneal intraepithelial neoplasia (CIN),

early, of conjunctival autografting,

Conjunctival limbal autograft (CLAU),

67

185–187

194–200

limbal stem cell deficiency in, 128

late, of conjunctival autografting,

donor tissue for, 155–156

Corneal melting, from mitomycin C

187–188

history of, 233

administration, 82

of prosthokeratoplasty, 266–267

for treating iatrogenic limbal stem

Corneal wounds

of thio-tepa therapy for pterygium, 79

cell deficiency, 133

arresting ulceration, Tenon’s

Composite graft, preparation for,

for treating pterygium, 84

advancement for, 107

procedure, 236–237

for treating unilateral limbal

healing of, 28

Congenital erythrokeratodermia,

deficiency, 269

tetracycline for treating recurrent

functional impairment of stem

Conjunctival rotational autografting,

erosions, 54

cells in, 30–31

188–190

Corneoscleral crescent technique of

Conjunctiva

Conjunctival transdifferentiation, 168–174

Holland/Schwartz, for

anatomy and function of, 6–7

as the basis for conjunctival

keratolimbal allograft, 209–212

condition of, and staging of ocular

autografting, 194–195

Corneoscleral dellen formation, as a

surface disease, 163–166

Conjunctival transplantation, 149

complication of conjunctival

deficiency of, stem cell dysfunction

for repair of the ocular surface, 232

autografting, 186–187

originating in, 128

Contact burns, 109–110

Corneoscleral perforation, in

dysfunction of, with limbal stem cell

Contact lenses

conjunctival autografting, 185

disease, managing, 269–270

giant papillary conjunctivitis

Corneoscleral rim technique, for storage

etiology of inflammation of, and

associated with, 24

of tissue before keratolimbal

preoperative staging, 160–163

hydrophilic therapeutic bandage, for

allografting, 224–225

extent of disease in, as a preoperative

protecting healing epithelium, 62

Corneoscleral ring technique of Tsubota

staging factor, 160

limbal deficiency associated with, 31,

for keratolimbal allograft, 212–217

inflammation of

194

Corticosteroids

chronic, 21–22

limbal stem cell deficiency associated

systemic

in collagen vascular disease, 24

with, 128

for management of limbal stem cell

acute, 20–21

Contraindications

transplant patients, 246

unilateral disease of, managing, 269

to amniotic membrane

for treating cicatricial pemphigoid,

Conjunctival allograft (CAL)

transplantation, 229

117

designation by donor source, living

to conjunctival limbal allografts,

topical

relative or cadaveric, 107

living-related, 201–202

for local immunosuppression, 245

living related, procedure, 153

to conjunctival limbal autografts, 194

for medical management of

Conjunctival autograft (CAU), 107,

to corneal transplantation in

iatrogenic limbal stem cell

149–152, 175–193

cicatricial pemphigoid, 118

deficiency, 132

harvesting of, 182–184

to cyclosporin A administration,

for treating cicatricial pemphigoid,

orientation of, 183

247–248

116

size of, 182

to ex-vivo composite grafting, 235

for treating dry eye, 53

for treating pterygium, 75–78, 83–84

to sequential sector conjunctival

for treating alkali burns, early

Conjunctival flap

epitheliectomy, 169–170

phase, 106

for recruiting conjunctival

See also Side effects

for treating dry eye, dosage and

vasculature, 139–143

Cornea

duration, 53

sliding, for treating pterygium, 75

anatomy and function of, 7

Cryotherapy, for treating trichiasis,

Conjunctival graft, amniotic membrane

degeneration of, in neurotrophic

117

graft as an alternative to, 228

keratitis, 62

Cryptophthalmos, 97–98

Conjunctival granulomas

epithelialization of, 201

Cutaneous disease, in blepharitis, 39

delayed, from mitomycin C

surgery involving

Cyanoacrylate glue

administration, 82

with amniotic membrane graft for

for punctal occlusion, procedure of

as a postoperative complication of

surface reconstruction, 228–229

applying, 137

conjunctival autografting, 187

in rheumatoid arthritis, 123

temporary tarsorrhaphy using,

Conjunctival intraepithelial neoplasia

Corneal cautery, 142, 146–147

138–139

(CIN), as a limbal stem cell

Corneal dystrophies, anterior, 59–60

Cyclophilin, binding of cyclosporin A

disease, 32

Corneal epithelial stem cells, preserving

to, 247

Conjunctivalization

in preparation for keratolimbal

Cyclophosphamide, for treating

peripheral, in partial limbal stem cell

allografting, 213

inflammation in cicatricial

deficiency, 30

Corneal epithelium, removal of

pemphigoid, 118

sectoral, in stem cell transplantation

in conjunctival limbal autografting,

Cyclosporin A (CSA), 152

failure, 259–260

196

for immunosuppression

Conjunctival limbal allograft (CLAL)

before advancement of a flap, 141

before allografting, 235

designation by source, living relative

Corneal grafting, in the context of stem

after conjunctival limbal

or cadaver, 107, 133

cell deficiency, 253–256

allografting, 206

276

Index

Cyclosporin A (CSA) (Contd.)

selecting in conjunctival limbal

prednisolone, for

after homologous penetrating

allografting, 202

immunosuppression, in

central limbokeratoplasty, 220

Donor tissue

conjunctival limbal allograft, 206

in transplantation, 246–249

for conjunctival limbal allografting,

thio-tepa (N,N ,N -

site of inhibition of cytokine

harvesting of, 202–204

triethylenethiophosphoramide),

production, 244–245

for conjunctival limbal autografting,

for treating pterygium, 79

systemic, in limbal stem cell

harvesting of, 197–199

See also Azathioprine (Imuran);

transplantation, 247–248

corneoscleral rim, from an eye bank,

Corticosteroids; Cyclosporin A

topical, in limbal stem cell

217

(CSA); Doxycycline;

transplantation, 247

for epithelial transplantation, 155

Methotrexate; Mitomycin C

for treating dry eye inflammation,

biopsy to confirm suitability, 235

(MMC); Prednisone; Retinoic

53–54

for keratolimbal allografting

acid; Steroids; Tetracyclines

Cytochrome P450 system

from eye banks, 223–225

Dry eye, 49–64

drugs affecting, interactions among,

preparation of, 209–210, 212–216

association with blepharitis, 43

248

placement of

Dye staining, diagnostic, in dry eye, 51

metabolism of tacrolimus by, 249

in conjunctival limbal autografting,

Dysautonomia, familial (Riley-Day

Cytokines

199–200

syndrome), 27

of the corneal epithelium and

in keratolimbal allografting, 212,

Dystrophic changes, in pterygium, 72

conjunctival cells, 30

217

Dystrophies

role in graft rejection, 243

preparation of, for keratolimbal

avellino corneal, 61

allografting, 224

Cogan’s, 59–60

Daclizumab (humanized anti-Tac),

risks to the donor in harvesting,

corneal, recurrent erosion syndrome

blocking of IL-2 by, 251

195–196, 235

in, 59

Dapsone, for treating cicatricial

Dorzolamide, for managing intraocular

of the corneal epithelium and stroma,

pemphigoid, 116–118

pressure, in alkali burn

gene mutations in, 32

Dermatitis herpetiformis (Duhring), 17

treatment, 105

Dermatochalasis, from dysfunction of

Doxycycline

Ectodermal dysplasia, 95–97

the upper lid retractors, 5

for altering the character of

Ectrodactyly-ectodermal dysplasia-

Descemetocele

meibomian gland secretions, 46

clefting syndrome (EEC), 95–97

gluing, temporarily, in alkali burn

for treating acne rosacea, 54

Ectropion, from dysfunction of the

treatment, 105–108

Drugs

orbicularis oculi muscle, 5

penetrating keratoplasty for, in alkali

allopurinol, interaction with

Endophthalmitis, from bacterial

burn treatment, 107–108

azathioprine, 249

keratitis, 118–119

Descemet’s membrane, of the cornea, 7

bacitracin, for treating blepharitis,

Endothelium, of the cornea, 7

Desmosomes, of corneal wing cells, 7

44

Entropion

Diabetes, as a side effect of tacrolimus,

basiliximab (Simulect), blocking of

association with cicatricial

249

IL-2 by, 251

pemphigoid, treating, 117

Diagnosis

benzalkonium chloride, ocular

from disinsertion of the lower lid

of cicatricial pemphigoid, criteria for,

surface epithelial toxicity of, 53

retractors, 5

116

beta-blockers, for managing

Epidemiology

of dry eye

intraocular pressure, 105

of chemical injuries, 100–109

algorithm for, 49–52

brimonidine tartrate, 105

of pterygium, 70

tests for, 50–52

cevimeline, for stimulating tear

of thermal injuries, 109–110

Differential diagnosis

secretion in dry eye, 53–54

Epidermis, dendritic cells of, 4

of pterygium, atypical, 72

ciprofloxacin, for preventing

Epidermolysis bullosa, keratolimbal

of Stevens–Johnson syndrome, 120

microbial keratitis, 105

allografting in, 97

Disorders, dermatologic, involving the

cyclophosphamide, for treating

Epidermolysis bullosa acquisita, 17–18

basement membrane of the

inflammation in cicatricial

Episcleritis, in rheumatoid arthritis, 121

eyelid, 4–5

pemphigoid, 118

Epithelial adhesion disorders, 58–64

Dissection, superficial, technique for in

dapsone, for treating cicatricial

Epithelial inclusion cysts, as a

conjunctival autograft

pemphigoid, 116–118

postoperative complication in

harvesting, 182

depletion of goblet cells with

conjunctival autografting, 187

DNA repair, abnormalities of, in

prolonged use of, 19

Epithelialization, enhancing, in alkali

pterygium tissues, 73

dorzolamide, for managing

burn treatment, 105

DNA synthesis, blocking of, by

intraocular pressure, in alkali

Epitheliectomy, sequential conjunctival,

azathioprine, 249

burn treatment, 105

for managing iatrogenic limbal

Donors

glucocorticosteroids, for preventing

stem cell deficiency, 133

of corneal epithelial stem cells,

graft rejection, 245–246

Epithelium

dangers to, 240

interactions with cyclosporin A, 248

of the conjunctiva, 6–7

screening for blood-borne diseases,

methylprednisolone, for treating dry

of the cornea, 7

202

eye, 53

Erosion, corneal recurrent, 59–62

278

Index

History (Contd.)

after keratolimbal allografting,

IL-2

ocular, in dry eye evaluation, 49

221

blocking of action of, by

of prosthokeratoplasty, 263

in ocular surface transplantation,

monoclonal antibodies, 251

of surgical excision of a pterygium,

154–155

blocking of transcription of, by

75

Impression cytology, for identifying

tacrolimus, 248

Homologous penetrating central

goblet cells noninvasively on the

release by helper T-cells, 243

limbokeratoplasty (HPCLK), 208

corneal surface, 29

Intraocular pressure, controlling, in

technique of Sundmacher, 217–221

Incidence

alkali burn treatment, 105

Hormonal control, of meibomian gland,

of cicatricial pemphigoid, 114

Intraoperative strategies for successful

43–44

of Stevens–Johnson syndrome, 118

transplantation, 261

Hughes-Roper-Hall classification

Indications

In vitro culture, of stem cells on

of acid injuries, 109

for amniotic membrane

collagen shields, 234

of alkali injuries, 102–105

transplantation, 228–229

Irradiation

Human leukocyte antigen (HLA)

for conjunctival limbal allograft,

goblet cell deficiency due to, 20

anti-allograft response involving,

living-related, 201

limbal stem cell dysfunction due to,

244–245

for conjunctival limbal autograft, 194

30

in epithelial cells, and transplant

for ex-vivo composite grafting, 235

Irrigation

rejection, 232

for keratolimbal allograft, 208–209

in acute treatment of acid burns, 109

matching, for conjunctival limbal

for prosthokeratoplasty, 266

in acute treatment of alkali burns,

allograft donor selection, 202

for sequential sector conjunctival

103–105

and transplant rejection, 243

epitheliectomy, 168–169

Islets of Fuchs, 65

Human papilloma virus, as an etiological

Infections

factor in pterygium, 71

association with neurotrophic

Keratectomy, superficial, 147

Hyaline deposits, in granular

keratitis, 62

Keratinization

dystrophy, 60

association with Stevens–Johnson

and risk of keratolimbal allograft

Hydrofluoric acid, burns from, 108–109

syndrome, 18–19

failure, 161–162

Hyperemia, in conjunctival

conjunctival, goblet cell deficiency

and risk of limbal stem cell

inflammation, 20

due to, 19–20

transplantation failure, 259, 261

Hyperglycemia, in tacrolimus

of the skin of the eyelid, 39

Keratinocytes, of the eyelid epidermis, 4

administration, 249

Inflammation

Keratitis

Hyperlipidemia, in cyclosporin A

in alkali burns, 101

bacterial, association with

administration, 248

corticosteroid treatment for, 106

Stevens–Johnson syndrome,

Hyperplasia, epithelial, from ultraviolet

chronic

118–119

exposure, in mice, 71

as a risk factor in pterygium, 71

dominantly inherited, 94–95

Hypertension, ocular, steroid-induced

of the eyelid, 44

sclerosing, in rheumatoid arthritis,

complication of conjunctival

conjunctival

121

autografts, 187–188

and staging of ocular surface

stromal, in rheumatoid arthritis, 121

use of loteprednol to correct, 245

disease, 166

Keratitis-ichthyosis-deafness (KID)

and success of keratolimbal

syndrome, 97

Iatrogenic limbal stem cell deficiency,

allografts, 209

Keratitis sicca

31, 128–133, 208–209

as a contraindication to

secondary, in cicatricial pemphigoid,

clinical example, 271

conjunctival limbal allografting,

116

Immunofluorescence microscopy, to

202

treatment of, in cicatricial

identify immunoglobulins or

involving the meibomian glands, 5–6

pemphigoid, 117

complement at the basement

mycophenolate for management of,

Keratoconjunctivitis sicca (KCS)

membrane, 116

250

aqueous tear production in, 52

Immunoglobulins, identification of, in

nonimmunologic, as a factor in

association with rheumatoid arthritis,

cicatricial pemphigoid, 116

transplant failure, 259, 261

121–122

Immunosuppression

response of the conjunctiva to, 6

autologous serum for treating, 53

in conjunctival limbal allografting,

Inflammatory bowel disease,

in rheumatoid arthritis, 9

206

conjunctival inflammation

Keratoepithelioplasty (KEP), 149–151,

postoperative, in stem cell

associated with, 19

232–233

transplantation, 262

Inflammatory cells, identification of, in

history of, 208

in preparation for allogeneic

cicatricial pemphigoid, 116

Keratolimbal allograft (KLAL), 107, 156,

transplantation, 235

Innervation, of the orbicularis oculi, by

208–222

for reducing scarring and

the seventh cranial nerve, 5

advantages and disadvantages of, 201

conjunctival inflammation in

Interferon- , role in response to donor

failure of, to maintain phenotypic

cicatricial pemphigoid, 117–118

tissue, 243

corneal epithelium, 201

systemic

Interleukins

procedure for, 151–153

and complicating medical

IL-1, effect of tetracyclines on

recommendations for eye banks,

conditions, 163

production of, 54

223–225

280

Index

Meibomian gland disease (Contd.)

Mucoid discharge, in dominantly

Papillary hypertrophy, in chronic

diagnosis of, tests for, 52

inherited keratitis, 94–95

conjunctival inflammation, 21–22

fluorescein clearance test for

Mucous layer, dyes for evaluating the

Paradigm, logical, for management of

evaluating, 51

integrity of, 51

severe ocular surface disease,

treating, 46

Müller’s muscle, 3, 5

269–272

Meibomian glands

Multiple endocrine deficiency,

Parasitic infestations, of the eyelashes,

secretions of

functional impairment of stem

39

in blepharitis, 40–43

cells in, 30

Patching, with amniotic membrane, 229

in the tear film, 9, 25

Muscarinic cholinergic receptor

Pathoanatomy of epithelial adhesion,

in the tarsal plates, 5

antibodies, anti-M3, in Sjögren’s

58–59

Melanocytes, of the eyelid skin, 4

syndrome patients, 52

Pathogenesis

6–Mercaptopurine, conversion of

Mycophenolate, as a cyclosporin A-

of acid burns, 108–109

azathioprine to, 249

sparing agent, 248

of damage from alkalis, 100–102

Metalloproteinase

Mycophenolate mofetil (Cellcept),

of neurotrophic keratitis, 62–63

in pterygium tissue, cultured, 73

selective inhibition of inosine

of pterygium, 71–75

upregulation in recurrent erosion

monophosphate dehydrogenase

of recurrent erosion syndrome, 61

syndrome, 61

by, 249

in thermal injuries, 110

Metalloproteinase tissue inhibitors,

Pathology

recombinant, 106

Nasal-lacrimal reflex tearing, absence

coexistent, in conjunctival limbal

Methotrexate

of, in keratoconjunctivitis

autografting, 196

for treating cicatricial pemphigoid,

sicca, 52

of limbal stem cell deficiency, 29

118

Nasal mucosa, as a source for grafts in

Pathophysiology, conjunctival, 16–24

for treating rheumatoid arthritis, 121

chemical burn treatment, 108

Pediatric donors, for keratolimbal

Methylprednisolone, for treating dry

National Eye Institute, 49

allograft, 223

eye, 53

Necrosis, after graft inversion in

Pediatric patients, special

Minnesota Lions Eye Bank (MLEB),

conjunctival autografting, 186

considerations in treating, 163

protocol for keratolimbal

Necrotic tissue, removing, in alkali

Pemphigoid, cicatricial. See Cicatricial

allograft recovery, processing

burns, 105

pemphigoid

and preservation, 224–225

Neoplasia

Pemphigus vulgaris, conjunctival

Mites, hair-follicle, in the eyelashes, 39

conjunctival intraepithelial, as a

changes in, 17

Mitomycin C (MMC)

limbal stem cell disease, 32

Penetrating keratoplasty (PK)

as an adjunct to surgery, in treating

sebaceous, of the meibomian gland,

in aniridia, 93

pterygium, 80–83

44

failure of, 176

classification of the severity of

Nephrotoxicity

historic pattern, 9

damage from, 166

of cyclosporin A, 248

further surgery following, 162

limbal stem cell deficiency following

of tacrolimus, 249

limbal stem cell deficiency following,

use of, 131

Neurologic toxicity

131

for treating cicatricial pemphigoid,

of cyclosporin A, 248

in ocular stem cell disease, 253–256

local injections for, 118

of tacrolimus, 249

in severe alkali injury, 108

for treating pterygium, 75

Neurotrophic keratitis, 62–63

Periarteritis nodosa, conjunctival

with and without surgery,

Non-invasive tear break-up time

inflammation in, 24

recurrent rates, 176

(NIBUT), methods for, 50

Peripheral ulcerative keratitis (PUK),

postoperatively, 79

Nonsteroidal anti-inflammatory drugs

destruction in, 122–123

Monitoring

(NSAIDs), in alkali burn

Pfister classification, of chemical injury,

of cyclosporin A levels, 247–248

treatment, 106

104–105

of tacrolimus levels, 249

Nutritional deficiency, response of the

Phlyctenular disease, scarring of the

Monoclonal antibodies, reversal of

conjunctiva to, 6

corneal surface in, 45

acute graft rejection by, 250–251

Nutritional supplements, to modify

Phlyctenular keratoconjunctivitis,

Mortality, in rheumatoid arthritis with

meibomian gland secretion, 46

tetracycline for treating, 54

peripheral ulcerative keratitis,

Photochemical damage, sensitivity to,

123

Ocular surface transplantation,

in porphyria cutanea tarda, 19

Mucin phase

techniques for, 83–85

Photophobia, in dominantly inherited

disorders of, 28

Orbicularis oculi muscles, 5

keratitis, 94–95

of the tear film, 9–11

attachment of the skin of the eyelid

Photorefractive keratectomy, 227

Mucins

to lashes, 3

Phototherapeutic keratectomy (PTK),

dysfunction in production of, 16

Orbital septum, 3

147

hypersecretion of, 16

use of amniotic membrane

production of, by goblet cells of the

p53 oncogene, as a potential marker for

transplantation following, 227

conjunctiva, 6

pterygium, 71, 73

Phthirus pubis, in the eyelashes, 39

Mucocutaneous disease, goblet cell

Pannus, accompanying corneal

Physical injury, goblet cell deficiency

deficiency associated with, 17

opacities, 97

due to, 20

Index

281

Pilocarpine, for stimulating tear

Pseudopterygium, defined, 65–66

late, of alkali burn recovery, 103–105

secretion in dry eye, 53–54

Pterygium, 65–89

Retinoic acid

Pinguecula

clinical example, 271

all-trans ointment, for treating

defined, 65–67

conjunctival autografting for

keratinization in

progression of, to pterygium, 72

managing, 149, 175

Stevens–Johnson syndrome,

Polymethylmethacrylate (PMMA),

excision of, 177–181

120

tolerance of the eye for, 263

excision in recurrence of, 181–182

and limbal progenitor cell

Porphyria cutanea tarda, 19

pathophysiology of, limbal stem cell

differentiation, 16–17

Postmitotic cells (PMC), 151

malfunction in, 32

prevention of conjunctival

Postoperative management

primary, annular conjunctival graft

transdifferentiation with, 29

of composite graft patients, 237–238

in, 191–192

topical, for medical management of

of conjunctival autograft patients, 184

Ptosis

iatrogenic limbal stem cell

of conjunctival limbal allograft

botulinum toxin-induced, 55, 138

deficiency, 132

patients, 206

for minimizing ocular surface

See also Vitamin A

of conjunctival limbal autograft

exposure in dry eye, 53

Retractors, eyelid, 3, 5

patients, 200

from dysfunction of the upper lid

Rheumatoid arthritis (RA), 121–123

of keratolimbal allograft patients, 221

retractors, 5

association of keratoconjunctivitis

in limbal stem cell transplantation,

Punctal occlusion

sicca with, 24

262

procedures for, 137–138

association of ocular pemphigoid

in sequential sector conjunctival

for treating severe aqueous tear

with, 17

epitheliectomy, 172–173

deficiency, 53–55

Rheumatoid factors, association with

Prednisolone, for immunosuppression,

Punctate keratitis, from mitomycin C

Sjögren’s syndrome, 52

in conjunctival limbal allograft,

administration, 82

Risk factors, for pterygium, 70–71

206

Rosacea

Prednisone

Recipient eye, preparation of

cytokines produced in, 44

for managing limbal stem cell

in conjunctival limbal allografting,

meibomian gland disease caused by,

patients, 246

204–205

26

for treating inflammation in

in conjunctival limbal autografting,

Rose bengal dye

cicatricial pemphigoid, 117

196–197

for evaluating the integrity of the

Preoperative factors

in homologous penetrating central

pre-ocular mucous layer, 51

in conjunctival limbal autografting,

limbokeratoplasty, 217

staining scores, in Sjögren’s

195–196

in keratolimbal allografting, 210–212,

syndrome, 52

in ex-vivo stem cell expansion

216

techniques, 235–236

Reconstruction of the ocular surface,

Salivary gland, transplantation of, in

in keratolimbal allografting, 209

201

dry eye, 55

in sequential sector conjunctival

Rectus muscle, disinsertion of, in

Salleras procedure, for corneal cautery,

epitheliectomy, 170

conjunctival autografting, 185

142, 146–147

for staging disease severity, 159

Recurrence, of pterygium

Salzmann’s nodular degeneration, 44,

strategies for improving outcomes in

causes of, 184

59

limbal stem cell transplantation,

after conjunctival autografting, 83–84

Scarring

261

in conjunctival autograft versus bare

reduction of, by amniotic membrane

Presentation

sclera excision, 175–177

transplantation, 227

of cicatricial pemphigoid, 113–114

excision in, 181–182

stromal, as a complication in

of Stevens–Johnson syndrome, 118–119

procedures for preventing, 72

conjunctival autograft, 188

Proliferation, in pterygium, 72

relating to morphology, 70

subepithelial, in chronic conjunctival

Prophylactic therapy, for reducing the

risks of excision in, 78–79

inflammation, 21

side effects of systemic steroid

after rotational conjunctival

Schirmer test, 10

therapy, 246

autografting, 189

for evaluating tear clearance, 12

Prostaglandins, effect of

Referral sources, education of, by eye

for measuring aqueous tear secretion,

glucocorticosteroids on synthesis

banks, 223

51

of, 245–246

Reis-BÅcklers’ dystrophy, 60

and risk of keratolimbal allograft

Prosthokeratoplasty, in ocular surface

Reiter’s syndrome, goblet cell loss in, 19

failure, 161–162

disease, 263–268

Rejection

Schnyder’s crystalline dystrophy, 61

Protease inhibitors, of amniotic

in corneal surgery, effect of amniotic

Sclera excision, bare, for pterygium,

membrane, 227

membrane grafts on, 229

76–78

Protractors, of the eyelid, 3, 5

of keratolimbal allografts, early,

Scleritis, in rheumatoid arthritis, 121–122

Pseudoglandular hyperplasia, 16

258–259

Sclerocornea, 95

Pseudomembranes, formation of, in

mechanism of, 243–245

Scleroderma, conjunctivitis in, 19

conjunctival inflammation, 20

See also Immunosuppression

Sebaceous glands, lacrimal, 10–11

Pseudopemphigoid, drug-induced,

Repair phase

Secretogogues, for treating dry eye, 54

goblet cell deficiency in, 19

early, of alkali burn recovery, 102–105

Senter syndrome, 97

282

Index

Sequential conjunctival epitheliectomy,

transplantation of

for treatment of dry eye, 54–55

260

in cicatricial pemphigoid, 118

Surgical techniques

for managing iatrogenic limbal stem

early failure in, 258–259

in conjunctival autografting, for

cell deficiency, 133

in Stevens–Johnson syndrome, 120

pterygium, 177–188

Sequential sector conjunctival

late failure in, 259–260

in conjunctival limbal allografting,

epitheliectomy (SSCE), 168–174

See also Limbal stem cells

202–205

Side effects

Steroids

in conjunctival limbal autografting,

of azathioprine, 249

for donor management, in

196–199

of cyclosporin A, monitoring of,

conjunctival limbal allograft, 206

in expanded epithelial cell

247–248

for immunosuppression, in

transplantation with amniotic

of mycophenolate mofetil, 249–250

conjunctival limbal allograft, 206

membrane substrate, 237

of pilocarpine, 54

systemic, for management of limbal

in keratolimbal autografting, 209–221

of sirolimus, 250

stem cell transplant patients, 246

in sequential sector conjunctival

of systemic steroids, 246

See also Corticosteroids

epitheliectomy, 170–172

of tacrolimus, 249

Stevens–Johnson syndrome (SJS), 18–19,

Suture

of topical steroids, 245

118–121

breakage of, after conjunctival

Silicone plugs, for punctal occlusion, 137

amniotic membrane transplantation

autografting, 186

Silver nitrate, burns from, 108

for treating, 154

for securing a conjunctival allograft,

Sirolimus (rapamycin, Rapamune),

clinical example, 272

204–205

immunosuppression with, 250

keratolimbal allograft for treating,

for securing a conjunctival autograft,

Sjögren’s syndrome

208–209

184, 199

aqueous tear deficiency associated

keratolimbal allograft with amniotic

in tarsorrhaphy, 139

with, 19, 25–27, 51

membrane for treating, 218–220

Symblepharon formation

autologous serum for treating, 53

prognosis, compared with aniridia,

following bare sclera excision for

tests distinguishing from non-

158

pterygium, 78

Sjögren’s causes, 52

symblepharon formation in, 162

in chronic conjunctival inflammation,

Skin, of the eyelid, 3–5

Stocker’s line, 65

21–22

Spasm, hemifacial, activity of the

Stratum spinosum (squamous layer), of

reduction of, in conjunctival limbal

orbicularis oculi in, 5

the eyelid, 4

allograft, 201

Squamous blepharitis, 41

Stroma

Sympathetic nervous system, regulation

Squamous cell carcinoma, of the

of the cornea, 7

of Müller’s muscle by, 5

conjunctiva, presentation as an

damage to, in ulcerative

Symptoms, of patients with dry eye, 49

atypical pterygium, 65

conjunctivitis, 20–21

Systemic inflammatory disease, goblet

Squamous metaplasia

Stromal corneal ulceration, from alkali

cell deficiency in, 19

progression of, in the eyelid, 6–7

burns, 101

in vitamin A deficiency, 16–17

Stromal dystrophies, 60–62

Tacrolimus (FK-506), for

Staging

Stromal puncture, anterior, procedure,

immunosuppression, 248–249

preoperative, of disease severity,

142, 145

Tarsorrhaphy

158–167

Stromelysin (MMP-2), in pterygium

for managing slow epithelial healing

of severe ocular surface disease,

tissue, 73

in conjunctival limbal allografts,

163–167

Strontium 90, as a beta source in

206

of stem cell transplantation followed

treating pterygium, 79–80

for minimizing ocular surface

by penetrating keratoplasty, 254

Subconjunctival fibrosis at a donor site,

exposure in dry eye, 53, 55

See also Classification

postoperative complication in

prior to stem cell transplantation, 261

Staphylococcal infection, angular

autografts, 187

procedure, 138–140

blepharitis caused by, 39

Substantia propria, of the eyelid, 6

Tarsus, 3, 5–6

Staphylococcal scalded skin syndrome,

Sulfuric acid, burns from, 108

T-cells

differentiating from

Sulfurous acid, burns from, 108

helper and cytotoxic, roles in graft

Stevens–Johnson syndrome, 120

Superior limbic keratoconjunctivitis, 24

rejection, 243

Stem cells

Superoxide free radicals, release in

response to glucocorticosteroids, 245

conjunctival epithelial, in the fornix,

alkali burns, 101

Tear break-up time (TBUT), as a

6

Surface regularity index (SRI), for

measure of tear film stability,

corneal epithelial

evaluating corneal surface

50–51

damage in ocular surface diseases,

regularity, 50

Tear clearance, measuring, 12

232

Surface stabilization, procedures for,

Tear deficiency

in the limbus, 8–9

137–148

association with Sjögren’s syndrome,

deficiency of

Surgeon, experience of, and recurrence

25

congenital, 93–99

rate in conjunctival autograft for

non-Sjögren, 27

in hypohidrotic ectodermal dysplasia,

pterygium, 175–176

Tear film

97

Surgery

anatomy and function of, 9–12

ocular, penetrating keratoplasty for

damage in, limbal stem cell

artificial, for managing dry eye and

treating diseases of, 253–256

deficiency from, 129–131

meibomian gland disease, 53